• Health Policy and Management
• /
• v.21 no.1
• /
• pp.44-60
• /
• 2011

Background : Surgical site infection(SSI) is one of the important nosocomial infections with pneumonia, urinary tract infection. SSI increases mortality, morbidity, length of stay, and costs for postoperative patients. The purpose of this study was to estimate length of stay(LOS) and health care costs from SSI using the large observational data. The ultimate objective was to show the effect of prevention of SSI. Method : This study used antibiotic prophylaxis evaluation data and claims data of the HIRA(Health Insurance Review and Assessment Service). The study population included 18,361 patients who underwent gastric surgery, endoscopic cholecystectomy, colon surgery, hysterectomy, cesarean section in nationwide hospitals from August to October 2007. SSI group and non-SSI group were matched according to propensity score resulted from logistic regression. The paired t-test was used to compare the difference of the LOS and health care costs between SSI group and non-SSI group. Results : The 598 cases of SSI were detected of total subjects, and the crude SSI rate was 3.3%. For each surgery, SSI rates were 5.5% for gastric surgery, 4.7% for cholecystectomy, 6.6% for colon surgery, 2.6% for hysterectomy, and 1.6% for cesarean section. The 596 cases of SSI and the 596 cases of non-SSI were matched by propensity score. The LOS of SSI group was longer than that of non-SSI group, and the difference was statistically significant. Health care costs of SSI group was more than that of non-SSI group which was significant. Conclusions : SSI increased apparently the LOS and healthcare costs. The economic loss might affect the cost of national healthcare as well as patients and hospitals. This study provided the evidence that the healthcare expenditure could be reduced by preventing SSI.

• Journal of Pharmacopuncture
• /
• v.19 no.3
• /
• pp.246-252
• /
• 2016

Objectives: The purpose of this study was to obtain a natural antibiotic from Phenol-rich compounds; for the dressing and the treatment of chronic wounds. Methods: The Phenol-rich compound sweet gel was prepared by blending four natural herbal extracts, Acacia catechu (L.F.), Momia (Shilajit), Castanea sativa, and Ephedra sinica stapf, with combination of a sweet gel medium, including honey, maple saps, Phoenix dactylifera L. (date), pomegranate extract and Azadirachta indica gum as a stabilizer. The combinations were screened by using a well-diffusion assay with cloxacillin as a control. Pseudomonas spp. was tested with our novel antimicrobial compound. The zones of inhibition in agar culture were measured for each individual component and for the compound, and the results were compared with those of the control group which had been treated with cloxacillin. Data were expressed as means ${\pm}$ standard deviations. Quantitative analyses were performed using the paired t-test. Results: The antibiotic effect of the Phenol-rich compound sweet gel was statistically shown to be more significant than that of cloxacillin against Pseudomonas aeruginosa (P < 0.05). Conclusion: Our novel approach to fighting the antibiotic resistance of Pseudomonas proved to be successful. The Phenol-rich compound sweet gel was found to be suitable for use as an alternative medicine and bioactive dressing material, for the treatment of patients with various types of wounds, including burns, venous leg ulcers, ulcers of various etiologies, leg ulcers on the feet of diabetic, unhealed graft sampling sites, abscesses, boils, surgical wounds, necrotic process, post-operative and neonatal wound infection, and should be considered as an alternative to the usual methods of cure.

• Journal of Microbiology and Biotechnology
• /
• v.31 no.5
• /
• pp.659-666
• /
• 2021

After Candida albicans, Candida glabrata is one of the most common fungal species associated with candidemia in nosocomial infections. Rapid acquisition of nutrients from the host is important for the survival of pathogens which possess the metabolic flexibility to assimilate different carbon and nitrogen compounds. In Saccharomyces cerevisiae, nitrogen assimilation is controlled through a mechanism known as Nitrogen Catabolite Repression (NCR). NCR is coordinated by the action of four GATA factors; two positive regulators, Gat1 and Gln3, and two negative regulators, Gzf3 and Dal80. A mechanism in C. glabrata similar to NCR in S. cerevisiae has not been broadly studied. We previously showed that in C. glabrata, Gln3, and not Gat1, has a major role in nitrogen assimilation as opposed to what has been observed in S. cerevisiae in which both factors regulate NCR-sensitive genes. Here, we expand the knowledge about the role of Gln3 from C. glabrata through the transcriptional analysis of BG14 and gln3Δ strains. Approximately, 53.5% of the detected genes were differentially expressed (DEG). From these DEG, amino acid metabolism and ABC transporters were two of the most enriched KEGG categories in our analysis (Up-DEG and Down-DEG, respectively). Furthermore, a positive role of Gln3 in AAA assimilation was described, as was its role in the transcriptional regulation of ARO8. Finally, an unexpected negative role of Gln3 in the gene regulation of ABC transporters CDR1 and CDR2 and its associated transcriptional regulator PDR1 was found. This observation was confirmed by a decreased susceptibility of the gln3Δ strain to fluconazole.

• Journal of Trauma and Injury
• /
• v.35 no.2
• /
• pp.76-83
• /
• 2022

Purpose: Ventilator-associated pneumonia is the most common nosocomial infection in patients with mechanical ventilation. In 2013, the new concept of ventilator-associated events (VAEs) replaced the traditional concept of ventilator-associated pneumonia. We analyzed risk factors for VAE occurrence and in-hospital mortality in trauma patients who received mechanical ventilatory support. Methods: In this retrospective review, the study population comprised patients admitted to the Jeju Regional Trauma Center from January 2020 to January 2021. Data on demographics, injury characteristics, and clinical findings were collected from medical records. The subjects were categorized into VAE and no-VAE groups according to the Centers for Disease Control and Prevention/National Healthcare Safety Network VAE criteria. We identified risk factors for VAE occurrence and in-hospital mortality. Results: Among 491 trauma patients admitted to the trauma center, 73 patients who received ventilator care were analyzed. Patients with a chest Abbreviated Injury Scale (AIS) score ≥3 had a 4.7-fold higher VAE rate (odds ratio [OR], 4.73; 95% confidence interval [CI], 1.46-17.9), and those with a glomerular filtration rate (GFR) <75 mL/min/1.73 m² had 4.1-fold higher odds of VAE occurrence (OR, 4.15; 95% CI, 1.32-14.1) and a nearly 4.2-fold higher risk for in-hospital mortality (OR, 4.19; 95% CI, 1.30-14.3). The median VAE-free duration of patients with chest AIS ≥3 was significantly shorter than that of patients with chest AIS <3 (P=0.013). Conclusions: Trauma patients with chest AIS ≥3 or GFR <75 mL/min/1.73 m² on admission should be intensively monitored to detect at-risk patients for VAEs and modify the care plan accordingly. VAEs should be closely monitored to identify infections early and to achieve desirable results. We should also actively consider modalities to shorten mechanical ventilation in patients with chest AIS ≥3 to reduce VAE occurrence.

• Korean Journal of Microbiology
• /
• v.49 no.3
• /
• pp.245-252
• /
• 2013

Pseudomonas aeruginosa and Acinetobacter baumannii are significant opportunistic pathogens in hospitals and are resistant to most antibiotics. Multidrug-resistant P. aeruginosa (MDRPA) and A. baumannii (MDRAB) cause severe human nosocomial infections and are more difficult to treat than methicillin-resistant Staphylococcus aureus (MRSA). Bifidobacteria are among of the most beneficial probiotics and have been widely studied for their antimicrobial activities. The present study explored the antimicrobial activity of Bifidobacterium sp. isolated from healthy Koreans against MDRPA and MDRAB. The antimicrobial activity of the isolates against MDRPA and MDRAB, which are resistant to ciprofloxacin, tobramycin, gentamicin, meropenem, and ceftazidime, was determined by modified broth microdilution methods using absorbance. Among all tested bifidobacteria isolates (nine B. adolescentis, three B. longum, and two B. pseudocatenulatum), the culture supernatant of B. pseudocatenulatum SPM1309 showed a strong growth inhibitory effect against MDRPA and MDRAB. No change in the turbidity of the mixture was observed during incubation, and its inhibitory effect occurred through bacteriostastic action. Moreover, the antibacterial activity was observed in the fraction with molecular weights <10 kDa of bifidobacteria culture supernatant, and the active fraction was heat-stable because it maintained its activity when heated at $70^{\circ}C$ for 10 min. The results suggest that this Bifidobacterium strain could have potential applications for alternative therapy in MDRPA and MDRAB infections.

• Korean Journal of Clinical Laboratory Science
• /
• v.48 no.2
• /
• pp.94-101
• /
• 2016

Acinetobacter species isolates are important opportunistic pathogens and commonly implicated in nosocomial infections. The therapeutic options for treatment of the bacterial infections are limited because the bacteria isolates are usually multidrug resistant (MDR). In the current study, we investigated various carbapenemase genes in 68 Acinetobacter species isolates. Antimicrobial susceptibilities were tested using the disk diffusion method. Screening of carbapenemase genes was performed via multiplex PCR. In addition, PCR and DNA sequencing were used to identify the carbapenemase genes. Repetitive extragenic palindromic-PCR (REP-PCR) was also performed to assess the clonality of isolates. In our study, A. baumannii isolates were highly resistant to all agents tested while all non-A. baumannii isolates were susceptible to all agents tested, with the exception of aztreonam and cefotaxime. All 51 A. baumannii isolates contained the $bla_{OXA-51}$ gene and 37 (72.5%) isolates also harbored the $bla_{OXA-23}$ gene. In addition, 39 MDR A. baumannii isolates were identified in our study and 37 isolates contained the $bla_{OXA-23}$ gene. The 37 MDR strains harboring $bla_{OXA-23}$ showed type I (n=22) or type II (n=15) banding patterns on their REP-PCR profiles. Our results suggest clonal relation and horizontal spreading of MDR A. baumannii isolates containing the $bla_{OXA-23}$ gene at the hospital located in Daejeon. Continuous investigation of antimicrobial resistant determinants and monitoring emergence and dissemination of MDR isolates is required to prevent and control infection and colonization of MDR A. baumannii isolates.

• Journal of Life Science
• /
• v.8 no.1
• /
• pp.40-50
• /
• 1998

Staphylococuus aureus and Escherichia coli is increasingly responsible for outbreaks of nosocomial infection around the world. Because serious infections due to these organisms currently necessiate use of non-$\beta$-lactam antimicrobial therapy and because strains is ofen resistant to many antimicrobial agents, infections with this organism are difficult to treat. Isolated strains from post operaton wounds of PNU hospital patient were tested for the antimicrobial susceptibility, resistant pattern and combined action to the 6 antibiotics. The minimal inhibitory concentraction of each antibiotic anc antibiotics combining in various ratios were measured by checkerboard dilution method. the synergism was determined through calculating the fractional inhibitory concentraction index (FICI). In case of S. aureus, 15 strains was shown to be highly sensitive to streptomycin and 13 strains to cephalothin. In case of E. coli, it is excellent senstitive 16 strains, sensitive 4 strains on cefoperazone, as like S. aureus, and thus the sensitive is most to be 66%. As the result of gaining MIC from S. aureus upon agar dilution method, MIC$_{50}$ was 8$\mu$g/ml, MIC$_{90}$ was 16$\mu$g/ml and thus the streptomycine is shown to be lowest. In case of E, coli, S. MIC$_{50}$ was 4$\mu$g/ml, MIC$_{90}$ was 16$\mu$g/ml, in streptomycin and thus is shown to be lower than S. aureus. As the result of comparing the resistance aspect of combining the antibiotics on S. aureus and E. coli, the resistant strain can be known to be reduced to the large range more than each 40% than combining with only aminoglycoside-series or cephalosporine-series. As the result of combining aminoglycoside-series, streptomycin and cephalothin or cefuroxime sensitive to S. aureus and E. coli in the above mentioned results, the increase or imporovement of effect is over 73% and 80%, respectively, thus the case od combining 2 antibiotics is shown to be better in the effect. Isolated strains from operating wounds were for the antimicrobial susceptibility. In case of S. aureus 15 strains was shown to be sensitive very much on streptomycin. In case of E. coli it is excellent sensitive 16 strains. As the results of combining aminoglycosides-series, streptomycin and cephalosporine series, cephalothin and cefuroxime, the increase or improvement of effect is over 73%, thus case of combining 2 antibiotics is shown to be better in the effect.

• Journal of Veterinary Clinics
• /
• v.20 no.3
• /
• pp.302-307
• /
• 2003

Although, in human medicine, strains of methicillin-resistant staphylococi have become the most important causative agents of nosocomial infections, studies on the small animals are very. limited. The aim of this study was to determine mecA gene and susceptibility to antibiotics of staphylococci strains isolated from clinically ill or healthy dogs and cats, during the period August 2002-July 2003. A total of 136 staphylococci (87 coagulase-positive and 49 coagulase-negative) were investigated for antibiotic resistance, using disk diffusion and minimum inhibitory concentration (MIC) test. The mecA gene was detected using the polymerase chain reaction. The isolates belonged to the species S. aureus (53 isolates), S. intermedius (34 isolates), S. epidermidis (26 isolates) and other coagulase-negative staphylococci (CNS, 23 isolates). Of the 136 isolates, 43 (31.6%) were mecA-positive and the frequency of the ,presence of mecA gene varied among the different species. All S. aureus strains were mecA-negative and were found to be susceptible, with an oxacillin MIC $\leq$1 $\mu\textrm{g}$/ml. Five (13.6%) isolates of 36 that exhibited oxacillin resistance on the MIC testing were found to be mecA-negative, suggesting not all mecA-positive strains may be an oxacillin resistant. However, the mecA presence of the strains was correlated with high oxacillin resistance: 71.4% (10 isolates of 14; P < 0.001) for mecA-positive S. intermedius and 72.4% (21 isolates of 29; P < 0.001) for mecA-positive CNS isolates. About 69% (94 isolates of 136) showed resistance to at least one drug, and 22.8% (31 isolates) were resistant to four or more different drug classes. Resistance (36 isolates, 71.7%) to penicillin G was a common finidng. This study suggest that the mecA-positive staphylococci are prevalent in small animals, and selection of antibiotics to treat infections caused by mecA-positive staphylococci may be very limited because of multi-drug resistance.

• Journal of the Korean Chemical Society
• /
• v.57 no.1
• /
• pp.81-87
• /
• 2013

Staphylococcus aureus is the most important pathogen in nosocomial infections, including bloodstream infections. Prompt identification of S. aureus from blood cultures and detection of methicillin resistance are essential in cases of suspected sepsis. We have studied a new method for the sequence-specific visual detection of minute amounts of nucleic acids using intercalating reaction by addition of SYBR Green to amplicons of LAMP, and it's a unique gene amplification method in which DNA can be isothermally amplified using only one enzyme. Staphylococcus-LAMP, which targets the spa gene, encoding S.aureus-specific protein A, and the mecA gene, encoding penicillin-binding protein-2' for methicillin resistance, detected MRSA and MRSE. In this study, by using LAMP assay, I detected for Staphylococcus aureus and Staphylococcus epidermidis concentration in the clinical sample. The detection of Staphylococcus aureus and Staphylococcus epidermidis was tested by using serial 10-fold dilutions standard solution. I have accurate detected the limit of detection, sensitity, specificity and reproducibility of the assay. The Bio-chip based LAMP assay allowed easy, rapid, accurate and sensitive detection of infection with Staphylococcus and especially applicable in a resource-limited situation.

• Korean Journal of Clinical Laboratory Science
• /
• v.54 no.2
• /
• pp.110-118
• /
• 2022

Candidemia is a major cause of nosocomial infections resulting in increased morbidity and mortality. It remains a serious risk in inpatients and increases medical treatment costs. From 2009 to 2018, Candida strains (3,533) isolated from blood culture tests at the S Hospital were analyzed according to the period, year, sex, age, ward, etc. During the entire period, 54,739 of 717,996 blood culture tests showed a positive rate (7.6%) and the Candida isolation rate was 3,533 (6.4%) out of 1,036 patients. Among the Candida isolates, C. albicans was most common (33.8%), followed by C. tropicalis (28.6%), C. glabrata (19.8%), C. parapsilosis (7.8%), and C. krusei (4.0%). In early (2009~2013)/late (2014~2018) isolation, C. tropicalis decreased by 3.8% and C. glabrata increased by 3.4%. After 50 years of age, the higher the separation frequency. C. parapsilosis (31.3%) in 1~10s, C. tropicalis (30.3%) and C. glabrata (27.6%) in 41~50s, and C. tropicalis (28.6%) in 80s are relatively frequent. has been separated C. krusei was isolated in a relatively high proportion from females (60.9%). Therefore, a systematic and continuous nosocomial infection control system should be established for appropriate treatment as per antifungal treatment guidelines. The system should continuously monitor the distribution of Candida species and provide rapid identification results.